How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $323.59 Median $5,370.32 Typical High $7,943.28 | Facility | None | $323.59 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $794.33 | Professional | None | $316.23 | $323.59 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $9,772.37 | Facility | None | $912.01 | $1,698.24 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $660.69 | Professional | None | $295.12 | $426.58 | $660.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $302.00 Typical High $426.58 | Professional | 62 · Two surgeons | $190.55 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $79.43 Typical High $112.20 | Professional | 80 · Assistant surgeon | $48.98 | $79.43 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $63.10 Typical High $89.13 | Professional | AS · PA/NP assist | $42.66 | $63.10 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $4,265.80 | Facility | None | $512.86 | $831.76 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $831.76 | Professional | None | $331.13 | $588.84 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $1,023.29 | Professional | None | $309.03 | $338.84 | $1,023.29 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $977.24 | Professional | None | $302.00 | $467.74 | $977.24 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $154.88 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $63.10 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $234.42 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $38.90 |
Where Georgia sits
The same service costs 3.9 times more in Wisconsin than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 19th of 51
$501
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.